| 1. |
- Biganzoli, L., et al.
(author)
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The requirements of a specialist breast centre
- 2020
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In: Breast. - : Elsevier BV. - 0960-9776 .- 1532-3080. ; 51, s. 65-84
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Journal article (peer-reviewed)abstract
- This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. The centrepiece of this article is the requirements section, comprising definitions; multidisciplinary structure; minimum case, procedure and staffing volumes; and detailed descriptions of the skills of, and resources needed by, members and specialisms in the multidisciplinary team in a breast centre. These requirements are positioned within narrative on European breast cancer epidemiology, the standard of care, challenges to delivering this standard, and supporting evidence, to enable a broad audience to appreciate the importance of establishing these requirements in specialist breast centres. (C) 2020 The Authors. Published by Elsevier Ltd.
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| 2. |
- Jordal, Malin, 1973-, et al.
(author)
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Surgical Healthcare Interventions after Female Genital Mutilation/Cutting : A Review of the Evidence
- 2022
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In: CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY. - : IMR Press. - 0390-6663 .- 2709-0094. ; 49:6
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Research review (peer-reviewed)abstract
- Background: Female genital mutilation/cutting (FGM/C) is a global public health problem associated with an increased risk of physical, sexual, and mental health consequences. Surgical healthcare intervention may alleviate negative health consequences related to FGM/C. In this review, we aim to offer an overview of documented effects of surgical healthcare interventions after FGM/C, from the perspectives of both healthcare providers (HCPs) performing such interventions and the women receiving them.Methods: We searched four databases (PUBMED/MEDLINE, CINAHL, PsychInfo, Cochrane Library) for peer-reviewed articles published between 2000 and 2021, and retrieved a total of 1978 citations (1203 + 775). After scrutinizing the citations with the inclusion criteria (1) observable outcomes of surgical healthcare interventions after FGM/C, (2) HCPs' perceptions of FGM/C-related surgical healthcare and experiences of providing surgical care for FGM/C-affected women, and (3) FGM/C-affected women's perceptions and experiences of the effects of FGM/C-related surgical healthcare, we selected 38 articles to include in this review.Results: HCPs and FGM/C-affected women differed in their views on surgical interventions. While providers seemed to suggest premarital defibulation regardless of a woman's age and marital status, affected women voiced social and marital concerns related to defibulation, which sometimes overrode the physical consequences. On the other hand, some providers were reluctant to perform intrapartum defibulation due to uncertainty or misinformation about infibulated women's wishes, while women often expected and desired defibulation prenatally. And while gynecologists demonstrated skepticism towards clitoral reconstruction, most women who had undergone the procedure were satisfied, particularly regarding the psychosocial and sexual aspects.Conclusions: Providers and recipients of surgical interventions after FGM/C seem to display contrasting views on surgical intervention after FGM/C, which may have implications for healthcare recommendations as well as satisfaction. This apparent ambiguity between providers' and recipients' perceptions of surgical interventions needs further investigation.
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| 3. |
- Tydén, Tanja, et al.
(author)
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Female university students' attitudes to future motherhood and their understanding about fertility
- 2006
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In: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 11:3, s. 181-189
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Journal article (peer-reviewed)abstract
- OBJECTIVES: As highly educated women tend to postpone childbearing, the purpose was to explore female university students' attitudes to future motherhood and their understanding about fertility. METHODS: Female students (n = 300), visiting a Student Health Centre in Sweden, answered a questionnaire with mainly multiple choice questions and verbal rating scales. RESULTS: The women wanted to have two to three children at the age of 29 for the first birth and 35 for the last. Only 2.7% did not plan to have any children. Six out of 10 would consider having an abortion if confronted with an unplanned pregnancy 'right now'. The most important circumstances for women's decision to have children were to be sufficiently mature, have a stable partner to share parenthood with, have completed studies and have a good economy. Having children before they got 'too old' was only ranked as very important by 18% of women. The women had an acceptable understanding about fertility. CONCLUSIONS: It appears that female university students are not very concerned about having children before they get 'too old'. Therefore, it is important that caregivers, working with contraceptive counselling also include information about fertility, especially to women who intend to postpone their motherhood.
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| 4. |
- Jordal, Malin, 1973-, et al.
(author)
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"Damaged genitals"-Cut women's perceptions of the effect of female genital cutting on sexual function. A qualitative study from Sweden
- 2022
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In: Frontiers in Sociology. - : Frontiers Media S.A.. - 2297-7775. ; 7
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Journal article (peer-reviewed)abstract
- Female genital cutting (FGC) is a traditional practice, commonly underpinned by cultural values regarding female sexuality, that involves the cutting of women's external genitalia, often entailing the removal of clitoral tissue and/or closing the vaginal orifice. As control of female sexual libido is a common rationale for FGC, international concern has been raised regarding its potential negative effect on female sexuality. Most studies attempting to measure the impact of FGC on women's sexual function are quantitative and employ predefined questionnaires such as the Female Sexual Function Index (FSFI). However, these have not been validated for cut women, or for all FGC-practicing countries or communities; nor do they capture cut women's perceptions and experiences of their sexuality. We propose that the subjective nature of sexuality calls for a qualitative approach in which cut women's own voices and reflections are investigated. In this paper, we seek to unravel how FGC-affected women themselves reflect upon and perceive the possible connection between FGC and their sexual function and intimate relationships. The study has a qualitative design and is based on 44 individual interviews with 25 women seeking clitoral reconstruction in Sweden. Its findings demonstrate that the women largely perceived the physical aspects of FGC, including the removal of clitoral tissue, to affect women's (including their own) sexual function negatively. They also recognized the psychological aspects of FGC as further challenging their sex lives and intimate relationships. The women desired acknowledgment of the physical consequences of FGC and of their sexual difficulties as "real" and not merely "psychological blocks".
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| 5. |
- Jordal, Malin, 1973-, et al.
(author)
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Swedish Gynecologists’ Positioning in Relation to Clitoral Reconstruction After Female Genital Cutting. A Qualitative Interview Study
- 2021
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In: International Journal of Sexual Health. - : Informa UK Limited. - 1931-7611 .- 1931-762X. ; 33, s. 76-87
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Journal article (peer-reviewed)abstract
- Background: Clitoral reconstruction (CR) is surgical reparation of the clitoris cut as part of the practice of female genital cutting (FGC) available in a handful of countries, including Sweden. The surgery aims at restoring the clitoris esthetically and functionally, thus has implications for sexual health. Gynaecological examinations can be an opportunity for dialogue regarding women’s sexual health. Gynecologist play a role in referring patients experiencing FGC-related problems, including sexual, to specialist services such as CR. Aim: The aim of this study was to explore how gynecologists position themselves in relation to CR. Method: Eight gynecologists were interviewed using semi-structured interviews. The interviews were tape-recorded, transcribed and analyzed using thematic analysis. Results: The gynecologists positioned themselves in three different ways in relation CR; outright negative, uncertain or positive toward the surgery. Those positioning themselves as negative thought CR was a harmful fraud and denied any possible benefits, at least sufficient for referral for CR. Those positioning themselves as uncertain did not deny possible benefits, but were skeptical toward CR improving cut women’s sexual health and function. Those positioning themselves positive considered the potential physical, psychological/emotional, esthetic, or symbolic aspects of CR as important for general well-being and sexual health. Conclusion: There was a great variety in how the gynecologists positioned themselves toward CR, and many were skeptical toward the functional benefits in relation to sexual health. This is likely to diverge cut women’s access to CR surgery.
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| 6. |
- Jordal, Malin, 1973-, et al.
(author)
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The benefits and disappointments following clitoral reconstruction after female genital cutting : A qualitative interview study from Sweden
- 2021
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In: PLOS ONE. - : PLoS. - 1932-6203. ; 16:7
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Journal article (peer-reviewed)abstract
- Female genital cutting or mutilation refers to the cutting of girls' external genitalia. Due to migration from contexts where female genital cutting is common, it is estimated that around 38 000 cut women and girls live in Sweden. Clitoral reconstruction, a relatively new form of surgical healthcare offered to women with female genital cutting, was established in Sweden in 2014. This surgery aims at restoring clitoral function and anatomy, but there is yet a dearth of evidence demonstrating the effects of the surgery. The aim of this study was to explore how women undergoing clitoral reconstruction in Sweden between 2016 and 2019 experienced the surgical process and its aftereffects from a physical, sexual and psychosocial perspective. Eighteen women who had undergone clitoral reconstruction at a university hospital in Sweden agreed to participate in the study. The women were interviewed using semi-structured interviews, which were recorded, transcribed and analysed using thematic analysis. The results, based on self-categorization and labelling theory, demonstrated both benefits and disappointments following the surgery. Several women reported positive outcomes in terms of sexual, psychosocial and aesthetic terms. They experienced reduced genital pain, improvements in their sex lives, and a sense of feeling more empowered and at ease in their bodies. Yet, some women reported aesthetic, functional and process-related disappointment related to clitoral reconstruction. Nonetheless, the women expressed gratitude for the possibility of undergoing the surgery. In conclusion, the women reported that they experienced physical, sexual and psychosocial benefits of the surgery.
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| 7. |
- Lampic, Claudia, 1964-, et al.
(author)
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Attitudes towards gamete donation among IVF-doctors in the Nordic countries - are they in line with national legislation?
- 2009
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In: Journal of Assisted Reproduction and Genetics. - : Springer Science and Business Media LLC. - 1058-0468 .- 1573-7330. ; 26:5, s. 231-238
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Journal article (peer-reviewed)abstract
- PURPOSE: To compare attitudes towards gamete donation between IVF doctors in the Nordic countries, and to determine whether attitudes are in correspondence with national legislation. MATERIALS AND METHODS: A study-specific questionnaire was used to study attitudes of 108 IVF doctors (92% response). Participants constituted 78% of all IVF doctors in Sweden, Denmark and Norway and 15% of IVF doctors in Finland. RESULTS: Despite similar legislation regarding offspring right to learn his/her donor's identity, IVF doctors from Norway reported significantly more negative attitudes towards disclosure than did Swedish physicians. A majority from all countries demonstrated positive attitudes towards embryo donation and allowing sperm donation for lesbian couples. Physicians reported strong support for anonymous donation but less support for 'known' donation. CONCLUSION: There are discrepancies between IVF doctors' attitudes towards gamete donation and national legislation in four Nordic countries. Negative attitudes towards disclosure to offspring may counteract legislative intentions.
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| 8. |
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| 9. |
- Lavesson, Tony, et al.
(author)
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Authors' response.
- 2013
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 50:1, s. 138-9
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Journal article (other academic/artistic)
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| 10. |
- Skoog Svanberg, Agneta, et al.
(author)
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Attitudes towards gamete donation among Swedish gynaecologists and obstetricians
- 2008
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In: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 23:4, s. 904-911
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Journal article (peer-reviewed)abstract
- BACKGROUND: Assisted reproductive technology (ART) legislation in Sweden has undergone a gradual transformation from being fairly restrictive when first introduced to becoming more permissive in recent years. Regarding gamete donation, Sweden became the first country to pass legislation about disclosure by establishing a child's right to find out the identity of the gamete donor once the child has reached maturity. Our aim was to investigate attitudes towards gamete donation among Swedish gynaecologists and obstetricians. METHODS: A questionnaire was mailed to all gynaecologists and obstetricians listed from a commercial register of all working in Sweden. Among 1230 eligible gynaecologists/obstetricians, 854 (69%) answered the questionnaire. RESULTS: In general, the majority of Swedish gynaecologists/obstetricians had positive attitudes towards gamete donation. Although a majority advocated openness regarding informing the child that he or she was conceived by making use of gamete donation, similar to 40% opposed allowing the child to receive any information about the donor when the child has reached maturity. Even though Swedish legislation has allowed sperm donation to lesbian couples since July 2005, one-third of the gynaecologists/obstetricians opposed donation to lesbians. CONCLUSIONS: The results indicate that the gynaecologists'/obstetricians' negative attitudes towards disclosure may influence patients' ability to discuss their thoughts and feelings about donation. This may also have a negative impact on donor recruitment as well as on the extent of methods made accessible within ART.
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